Provider Demographics
NPI:1003542747
Name:DELGADO, MARIESER (LPC)
Entity Type:Individual
Prefix:
First Name:MARIESER
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 MAIN ST APT 450
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-4722
Mailing Address - Country:US
Mailing Address - Phone:201-927-1619
Mailing Address - Fax:
Practice Address - Street 1:554 BLOOMFIELD AVE STE 401
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3307
Practice Address - Country:US
Practice Address - Phone:973-771-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00791000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional